Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | NPP33985 | RI |
NPI | 1023330362 |
---|---|
Provider Name | Karen Kawa |
First Address | Providence, RI 02903-4760 |
Second Address | East Providence, RI 02914-1430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2010 |
Last Update Date | 20/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023330362 | (05) | RI |
S66200 | (02) | RI |